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Meeting information needs in health policy and public health: priorities for the National Library of Medicine and The National Network of Libraries of Medicine.

Those seeking information in health policy and public health are not as well served as those seeking clinical information. Problems inhibiting access to health policy and public health information include the heterogeneity of professionals seeking the information, the distribution of relevant information across disciplines and information sources, scarcity of synthesized information useful to practitioners, lack of awareness of available services or training in their use, and lack of access to information technology or to knowledgeable librarians and information specialists. Since 1990, the National Library of Medicine and the National Network of Libraries of Medicine have been working to enhance information services in health policy and public health through expanding the coverage of the NLM collection, building new databases, and engaging in targeted outreach and training initiatives directed toward segments of the health policy and public health communities. Progress has been made, but more remains to be done. Recommendations arising from the meeting, Accessing Useful Information: Challenges in Health Policy and Public Health, will help NLM and the National Network of Libraries of Medicine to establish priorities and action plans for the next several years.

Health Policy↗

Mapping the distribution of conformational information throughout a protein sequence.

The three-dimensional structure of protein is encoded in the sequence, but many amino acid residues carry no essential conformational information, and the identity of those that are structure-determining is elusive. By circular permutation and terminal deletion, we produced and purified 25 Bacillus licheniformis beta-lactamase (ESBL) variants that lack 5-21 contiguous residues each, and collectively have 82% of the sequence and 92% of the non-local atom-atom contacts eliminated. Circular dichroism and size-exclusion chromatography showed that most of the variants form conformationally heterogeneous mixtures, but by measuring catalytic constants, we found that all populate, to a greater or lesser extent, conformations with the essential features of the native fold. This suggests that no segment of the ESBL sequence is essential to the structure as a whole, which is congruent with the notion that local information and modular organization can impart most of the tertiary fold specificity and cooperativity.

Amino Acid Sequence↗

[Impact of a program to improve appropriate prescribing of medications in residential facilities for older persons. Results after one year].

OBJECTIVE: To evaluate the impact after one year of a program to improve appropriate prescribing of medications, medical care products and supplies at a group of residential centers for older persons. DESIGN: Multicenter, controlled, quasi-experimental, before-after study of all outpatient prescriptions charged from each center to the Catalonian Health Service during the study period (reference year 2001, monitoring year 2002). SETTING: A total of 107 residential centers in the Barcelonés Norte y Maresme (Barcelona) health region. PARTICIPANTS: After situation analysis the centers were divided into two groups: intervention (n=21) and control (n=86). A total of 4789 older persons were residents at participating centers during the study. Interventions. The actions carried out in the intervention group were: a). letter describing the program; b). face-to-face interview to provide information; c). distribution of printed information about the study's aims and the indicators recorded, and d). monitoring with several follow-up interviews. MAIN MEASURES: We recorded quantitative indicators (general, specific and urinary incontinence products), qualitative indicators (use of medications with high intrinsic pharmacological value and generic pharmaceutical specialties) and relative drug use. The data were analyzed with a program written for Microsoft Access. RESULTS: In the intervention group we found that pharmaceutical costs were contained, a result we attributed to the greater efficiency achieved with the intervention (interannual increase of 0.7% in the reference period to 16.2% in the monitoring period; P=.000). The contribution of urinary incontinence supplies to cost reductions was noteworthy. Total costs in terms of numbers of packages dispensed for all therapeutic subgroups decreased by 4.8% (P=.000). The use of generic pharmaceutical specialties increased by from 7.9% to 13.1%, and the results for qualitative indictors for antiasthmatics and recommended NSAIDs also revealed improvements in prescribing quality. CONCLUSIONS: The preliminary results of the program show it to be effective in improving the efficiency of drug prescribing at participating nursing homes. The research method was useful in promoting the rational use of medications and improving the quality of prescribing practices.

Aged↗

Spectral distribution of prosodic information.

Prosodic speech cues for rhythm, stress, and intonation are related primarily to variations in intensity, duration, and fundamental frequency. Because these cues make use of temporal properties of the speech waveform they are likely to be represented broadly across the speech spectrum. In order to determine the relative importance of different frequency regions for the recognition of prosodic cues, identification of four prosodic features, syllable number, syllabic stress, sentence intonation, and phrase boundary location, was evaluated under six filter conditions spanning the range from 200-6100 Hz. Each filter condition had equal articulation index (AI) weights, AI = 0.01; p(C)isolated words approximately equal to 0.40. Results obtained with normally hearing subjects showed that there was an interaction between filter condition and the identification of specific prosodic features. For example, information from high-frequency regions of speech was particularly useful in the identification of syllable number and stress, whereas information from low-frequency regions was helpful in identifying intonation patterns. In spite of these spectral differences, overall listeners performed remarkably well in identifying prosodic patterns, although individual differences were apparent. For some subjects, equivalent levels of performance across the six filter conditions were achieved. These results are discussed in relation to auditory and auditory-visual speech recognition.

Adolescent↗

eHealth technology and Internet resources: barriers for vulnerable populations.

Disparities in accessing health information exist for various vulnerable populations. Reviewing access issues for those seeking and/or needing health information suggests that there are many factors that may inhibit access. These include a wide diversity in the education, background, and needs of those seeking information, and the distribution of information among many disciplines and information sources. The most needy among this group may require extensive, multispecialty healthcare and may have particular problems with access, treatment adherence, and working within the healthcare system.

Access to Information↗

EDGE: a centralized resource for the comparison, analysis, and distribution of toxicogenomic information.

Transcriptional profiling via microarrays holds great promise for toxicant classification and hazard prediction. Unfortunately, the use of different microarray platforms, protocols, and informatics often hinders the meaningful comparison of transcriptional profiling data across laboratories. One solution to this problem is to provide a low-cost and centralized resource that enables researchers to share toxicogenomic data that has been generated on a common platform. In an effort to create such a resource, we developed a standardized set of microarray reagents and reproducible protocols to simplify the analysis of liver gene expression in the mouse model. This resource, referred to as EDGE, was then used to generate a training set of 117 publicly accessible transcriptional profiles that can be accessed at http://edge.oncology.wisc.edu/. The Web-accessible database was also linked to an informatics suite that allows on-line clustering and K-means analyses as well as Boolean and sequence-based searches of the data. We propose that EDGE can serve as a prototype resource for the sharing of toxicogenomics information and be used to develop algorithms for efficient chemical classification and hazard prediction.

Animals↗

The World Wide Web: a review of an emerging internet-based technology for the distribution of biomedical information.

The Internet is rapidly evolving from a resource used primarily by the research community to a true global information network offering a wide range of databases and services. This evolution presents many opportunities for improved access to biomedical information, but Internet-based resources have often been difficult for the non-expert to develop and use. The World Wide Web (WWW) supports an inexpensive, easy-to-use, cross-platform, graphic interface to the Internet that may radically alter the way we retrieve and disseminate medical data. This paper summarizes the Internet and hypertext origins of the WWW, reviews WWW-specific technologies, and describes current and future applications of this technology in medicine and medical informatics. The paper also includes an appendix of useful biomedical WWW servers.

Computer Communication Networks↗

A cladistic analysis of Inaequalium (Coscarón & Wygodzinsky, 1984), with information on geographical distribution (Diptera: Simuliidae).

The black flies of the genus Inaequalium present a Neotropical distribution, with Panama at the northern limit, and the Argentinian pampas at the southern, but do not occur in the Central Amazon. This study offers a cladistic analysis establishing a hypothesis of relationships between the species of Inaequalium. A total of 37 characters have been considered in order to establish the hypothetic phylogenetic relationships. Cerqueirellum (Py-Daniel, 1983) was considered as outgroup. Data were analyzed using Henning 86 version 1.5. Wich the i.e.* command and implicit enumeration a unique possible cladogram was obtained in Inaequalium with 52 steps, and a CI of 0.76 and RI of 0.81. Two well-defined clades was obtained in the resulting cladogram, the "botulibranchium" species-group, includes I. travassosi, I. souzalopesi, I. botulibranchium and I. petropoliense, and the "inaequale" species-group, includes I. rappae, I. nahimi, I. inaequale, I. leopoldense, I. subnigrum, I. diversibranchium, I. mariavulcanoae, I. nogueirai, I. beaupertuyi, I. clavibranchium and I. subclavibranchium.

Animals↗

[Optimum ways of distribution of medical information among individuals with sexually transmitted infections].

The article is dedicated to the study of most rational ways of dissaminating medical information among persons suffering from those infections caught by sexual intercourse or genital contact. Optimum canals are determined of influence upon different age groups running a risk for this kind of pathology. The most optimum way of dissaminating information is television, newspapers, periodicals, mail.

Adolescent↗